Elevated N-terminal pro C-type natriuretic peptide is associated with mortality in patients undergoing transcatheter aortic valve replacement.

BACKGROUND: Unlike N-terminal pro-B-type natriuretic peptide (NT-proBNP), which have been extensively studied, little is known about the role of N-terminal pro-C-type natriuretic peptide (NT-proCNP) for predicting survival post transcatheter aortic valve replacement (TAVR). METHODS: A total of 309 patients were included in the analysis. Patients were grouped into quartiles (Q1-4) according to the baseline NT-proCNP value. Blood for NT-proCNP analysis was obtained prior to TAVR procedure. The primary endpoint was mortality after a median follow-up of 32 months. Multivariable Cox proportional hazards regression models analyzed prognostic factors. The predictive capability was compared between NT-proBNP and NT-proCNP using receiver operator curve (ROC) analysis. RESULTS: A total of 309 subjects with the mean age of 76.8 ± 6.3 years, among whom 58.6% were male, were included in the analysis. A total of 58 (18.8%) patients died during follow-up. Cox multivariable analyses indicated society of thoracic surgeons (STS)-score was a strong independent predictor for mortality (hazard ratio (HR) 1.08, 95% confidential interval (CI) 1.05-1.12, P < 0.001). Elevated NT-proCNP was associated with a higher risk of cardiovascular mortality (HR 1.02, 95% CI 1.00-1.03, P = 0.025) and All-cause mortality (HR 1.01, 95% CI 1.00-1.03, P = 0.027), whereas NT-proBNP showed a small effect size on mortality. ROC analysis indicated that NT-proCNP was superior to NT-proBNP for TAVR risk evaluation in patients with left ventricular ejection fraction (LVEF) < 50% [(Area under the curve (AUC)-values of 0.79 (0.69; 0.87) vs. 0.59 (0.48; 0.69), P = 0.0453]. CONCLUSIONS: NT-proCNP and STS-Score were the independent prognostic factors of mortality among TAVR patients. Furthermore, NT-proCNP was superior to NT-proBNP for TAVR risk evaluation in patients with LVEF < 50%. Trial registration NCT02803294, 16/06/2016.

The first four cases of successful NeoChord procedure in mainland China.

BACKGROUND: Transapical off-pump NeoChord procedure is a novel minimally invasive surgical repair of degenerative mitral regurgitation (MR). Here, we report the first four cases of NeoChord procedure in patients with mitral valve prolapse in mainland China. METHODS: Four patients, aged 86, 84, 80 and 60 years, with severe MR due to posterior middle scallop prolapse (P2), underwent transapical off-pump artificial chordae implantation on April 9 and 10, 2019. The procedure was performed by left mini-thoracotomy under general anaesthesia and guided by 2D and 3D dimensional transoesophageal echocardiography (TEE). RESULTS: Mitral valve repair via NeoChord procedure was successfully performed with implantation of 3 artificial chordae in the first patient and 3, 2, and 3 artificial chordae in the following patients, respectively. Intraoperative TEE and pre-discharge transthoracic echocardiography (TTE) showed only mild to moderate MR of these four patients and no postoperative complications were noted. There were no changes of TTE finding between one-month follow-up and pre-discharge. CONCLUSION: The successful NeoChord procedures in four Chinese indicate that the valve repair using the NeoChord system for Chinese population is feasible.

[Fibre-type differences in masseter muscle of Beagle dogs with implanted functional appliance therapy].

PURPOSE: To observe the changes of MyHC-I expression in masseter muscle of Beagle dogs with implanted functional appliance therapy，and to investigate the adaptive remodeling of masticatory muscle. METHODS: Eight, seven-month-old, male Beagle dogs were randomly assigned to experimental group and control group and were killed at 4,8,12 weeks during treatment and 4 weeks after the appliance removed(16 weeks). Serial cross-sections of superficial masseter muscle were cut and stained with MyHC-I antibodies.SPSS11.5 software package was used for statistical analysis. RESULTS: The positive expression rate of MyHC-I was 7.61% in the control group, and 20.43% in the experimental groups at 4 weeks﹙P<0.01﹚. The amount of type I fibres reached to peak at 8 weeks. With increase of treatment time, the amount of type I fibres gradually reduced. At 16 weeks, the amount of type I fibres was similar to the control groups. CONCLUSIONS: The expression of MyHC-I is significantly changed in masseter muscles of Beagle dogs with implanted functional appliance therapy. Implanted functional appliance forward mandibular displacement therapy can obviously promote the adaptive remodeling of masticatory muscle.

Magnetic Properties of a Single-Molecule Lanthanide-Transition-Metal Compound Containing 52 Gadolinium and 56 Nickel Atoms.

Monodisperse metal clusters provide a unique platform for investigating magnetic exchange within molecular magnets. Herein, the core-shell structure of the monodisperse molecule magnet of [Gd52 Ni56 (IDA)48 (OH)154 (H2 O)38 ]@SiO2 (1 a@SiO2 ) was prepared by encapsulating one high-nuclearity lanthanide-transition-metal compound of [Gd52 Ni56 (IDA)48 (OH)154 (H2 O)38 ]⋅(NO3 )18 ⋅164 H2 O (1) (IDA=iminodiacetate) into one silica nanosphere through a facile one-pot microemulsion method. 1 a@SiO2 was characterized using transmission electron microscopy, N2 adsorption-desorption isotherms, and inductively coupled plasma-atomic emission spectrometry. Magnetic investigation of 1 and 1 a revealed J1 =0.25 cm(-1) , J2 =-0.060 cm(-1) , J3 =-0.22 cm(-1) , J4 =-8.63 cm(-1) , g=1.95, and z J=-2.0×10(-3)  cm(-1) for 1, and J1 =0.26 cm(-1) , J2 =-0.065 cm(-1) , J3 =-0.23 cm(-1) , J4 =-8.40 cm(-1) g=1.99, and z J=0.000 cm(-1) for 1 a@SiO2 . The z J=0 in 1 a@SiO2 suggests that weak antiferromagnetic coupling between the compounds is shielded by silica nanospheres.

Combination of intermittent hydrostatic pressure linking TGF-ß1, TNF-α on modulation of proteoglycan 4 metabolism in rat temporomandibular synovial fibroblasts.

OBJECTIVE: This study was designed to evaluate the combined effects of intermittent hydrostatic pressure (IHP) and TGF-ß1 or TNF-α on proteoglycan4 (PRG4) expression in rat temporomandibular synovial fibroblasts (SFs). STUDY DESIGN: Rat SFs were isolated and expanded in monolayer cultures and subjected to IHP in the presence of TGF-ß1 or TNF-α. Quantitative real-time RT-PCR was applied to analyze the PRG4 expression levels. Enzyme-linked immunosorbent assay was also used for the quantification of PRG4 accumulation in the culture medium while immunofluorescence staining was used to detect intracellular PRG4 protein expression. RESULTS: The combination of IHP and TGF-ß1 induced greater PRG4 expression than either stimulus alone. In contrast, TNF-α inhibited PRG4 expression, and this was partially alleviated by IHP. CONCLUSIONS: Our study demonstrates a beneficial role of IHP, which can be used successfully in combination with TGF-ß1 to enhance PRG4 production, and can partially counteract TNF-α-induced PRG4 inhibition in isolated rat SFs.

[The effect of orthodontic treatment on facial profile of patients with Class II division 1 malocclusions].

PURPOSE: The purpose of this study was to determine the effect of orthodontic treatment on facial esthetic changes of Class II division 1 malocclusions through visual analogue scale(VAS) scores before and after treatment. METHODS: Reference photographs were selected first. 40 males and 40 females were randomly selected from the patients treated in our hospital. A set of photographs of each patient were shown to a panel .Then each face profile was rated on a VAS. Means and standard deviations (SD) were calculated for each set of photographs. One male and one female's photographs with an average aesthetic score close to the median value and lower SD were then selected to serve as reference photographs. Forty Class II division 1 malocclusion patients were randomly selected. A set of standardized photographs together with a set of reference photographs of the same gender were placed in random order to show to the panel.Facial aesthetics of the experimental subjects were scored on a VAS. Then the VAS scores both pretreatment and posttreatment were compared and analyzed using SPSS11.0 software package by one sample t test and paired t test. RESULTS: Two sets of reference photographs of one male and one female were selected. The mean of the patients prior to treatment was 43.839, and 48.328 after treatment. When the population mean was supposed to be 50,significant difference was noted prior to treatment with one sample t Test(P<0.05),while no significant difference was found after treatment(P>0.05). Paired t test showed that post-treatment scores were significantly higher than pre-treatment(P<0.01). CONCLUSION: The facial esthetic of Class II division 1 malocclusions were worse than the average, but can be improved through orthodontic treatment to approach an level.

[Soft tissue changes of upper lip in patients with class I malocclusion with different premolar extraction patterns].

OBJECTIVE: The purpose of this retrospective cephalometric study was to compare changes of the upper lip soft tissue in patients with Class I malocclusion after extraction of either first premolars or second premolars. METHODS: The pretreatment and posttreatment records of 50 patients were used in the study. And 25 patients involved extraction of first premolars and 25 patients involved the extraction of second premolars. The lateral cephalometric radiographs taken before and after treatment were traced and measured. 15 typical values of soft tissue were measured in Winceph 7.0 software and statistical analysis was carried by SPSS 10.0 software. RESULTS: 1) The horizontal and vertical lines were not significant different in the two extraction group before the treatment. But after the treatment the vertical changes of upper lip (A'-X, UL-X) were more apparent in the second premolar extraction group (P < 0.05). 2)In the soft tissue measurements, the values of Sn-A'-UL in the first premolar extraction group were less than those in the second premolar extraction group significantly before the treatment. After the treatment all the patients had a significant increase in length of upper lip. At the same time, UL-EP, A'-EP distances were diminished obviously (P < 0.05). But the changes were not significant difference between the two premolar extraction groups (P > 0.05). CONCLUSION: The upper lips both changed remarkably after the treatment and there was no significant difference between the two premolar extraction groups.

Lower incisor intrusion with intraoral transosseous stainless steel wire anchorage in rabbits.

The purpose of this research was to investigate the potential use of intraoral transosseous stainless steel wires as anchorage for intrusion of the lower incisors using a rabbit model. Placement of intraoral transosseous stainless steel wires around incisors is similar to that of intraoral transosseous wiring of edentulous mandibular fractures. Ten male New Zealand rabbits, 9 +/- 1.5 months of age, average weight 1.8 +/- 0.3 kg, were used in this study. One lower incisor was intruded with a 50 g bilateral force using a coil spring for 10 weeks, while the other incisor served as the control. Clinical measurements of the distances between the occlusal edges of the incisors (EE) were performed weekly with a calliper. In addition to standard descriptive statistical calculations, a paired Student's t-test was used for comparison of the two groups. All surgical sites healed uneventfully after insertion of the wires. Significant differences were found in the change of EE between the experimental and control sides from 4 weeks onwards. Intrusion of the incisor, 4 +/- 0.58 mm, was seen on the test side, while EE on the control side remained unchanged. Within the limits of this animal study, it is concluded that the intraoral transosseous stainless steel wire anchorage system is a cost-effective method for intrusion of lower incisors when the use of other anchorage system is not possible.

[Soft tissue changes of chin with different premolar extraction patterns].

PURPOSE: The purpose of this retrospective cephalometric study was to compare the change of chin soft tissue in patients with Class I malocclusion after extraction of either first premolars or second premolars. METHODS: The pretreatment and posttreatment records of 50 patients were used in the study. Twenty-five patients underwent extraction of first premolars and 25 patients underwent extraction of second premolars. All the patients were skeletal Class I and matched by the gender, age, facial divergence and crowding. The lateral cephalometric radiographs taken before and after treatment were traced and measured. The data was analyzed using SPSS 10.0 software package for Student's t test. RESULTS: (1)The horizontal and vertical changes was both significant in the second extraction group compared with first extraction group, and the horizontal change was more apparent. But only vertical change was apparent in the first extraction group. (2)In the soft tissue measurements, the value of soft tissue facial angle and B'-Pos-FH in the first extraction group was less than those in the second extraction group significantly. After treatment all the patients had an increase in S-Ns-Pos angle, soft tissue facial angle, B'-Pos-FH and depth of mentolabial groove. At the same time, soft tissue convexity angle was diminished obviously. But the change was not significant between the two premolar extraction groups. CONCLUSIONS: The growth pattern tends to vertical pattern in the first premolar extraction group and the horizontal growth of chin is more obvious in the second premolar extraction group. There is no significant difference of chin soft tissue changes between the two premolar extraction groups.

[Assessment of facial skeletal growth and response to implanted functional appliance therapy with three-dimensional images].

PURPOSE: To evaluate the facial skeletal growth and response to implanted functional appliance therapy with three-dimensional images. METHODS: Eleven male Beagle dogs (7 months old and in late mixed dentition) were randomly divided into four groups: implanted functional appliance group, semi-implanted functional appliance group, modified Forsus(TM) group and the control group. After the appliances were inserted in the experimental groups for 4, 8, 12 weeks and 4 weeks after the appliances were removed, the facial skeleton and teeth of the Beagle dogs digital information was obtained by using spiral computed tomography, then Mimics 8.1 software and a kind of retro-engineering software called qualify V8.0 were used to establish three-dimensional facial skeletal and dental images of the Beagle dogs. Three-dimensional structure changes of the facial skeleton and teeth in each group at different stages were assessed by the Bjork method, i.e. the superimposition technique based on the "best fit" of anterior cranial base structure and mandible metallic implants. RESULTS: Mandibles in the groups with implanted functional appliance, semi-implanted functional appliance, and modified ForsusTM were obviously displaced forward, while the growth of the maxilla was inhibited in some degree. The displacement of upper teeth in the group with implanted functional appliance was not obvious, while the distal movement of upper teeth in the group with semi-implanted functional appliance and modified ForsusTM was significant compared with that in the control group. CONCLUSIONS: The implanted functional appliance can significantly stimulate the growth of the mandible and avoid the unwanted movement of teeth which is frequently found in other functional appliances. Supported by Wenzhou International Cooperative Research Project (Grant No. B00260027).

[Longitudinal study of the stability and reproducibility of natural head position in adolescents with different facial types over time].

PURPOSE: The aim of this study was to investigate the stability and reproducibility of natural head position (NHP) in adolescents with three different facial types. METHODS: The material consisted of intact lateral cephalograms of 30 male subjects and 30 female subjects, taken at 6, 9, 12, 15, 18 years in NHP. These subjects were selected randomly and divided into three groups based on the MP-SN angle at approximately 15 years of age. Serial cephalometric roentgenograms traced upon the superimposition method based on the "best fit" of anterior cranial base structures. The changes of NSL/VER angulation were analyzed statistically. RESULTS: The standard deviation of the NSL/VER angulation at 6 year occasion, the mean incremental values, the standard deviation and the method error of NSL/VER angulation during the period from 6 years occasion to any other occasion were larger, the coefficient of reliability was much more lower than the others. The standard deviation and the mean incremental values among 9-year, 12-year, 15-year and 18-year occasions were lower. The coefficient of reliability range from 76% to 97% and the method error at these six periods ranged from 1.84 degrees to 3.48 degrees in three facial types. There was different natural head position in three different facial types with cross-sectional comparison. The angulation in LFT was significantly larger than AFT and HFT, and the values in HFT were the smallest. However, there were no significantly statistical differences in three facial types as the change magnitude of NHP over time was compared. CONCLUSIONS: These suggest that the NHP of children at 6 years occasion or during the period from 6 years to 9 years of age is highly variable and this situation should be paid attention on while the facial growth studies and the cephalometric radiogram are made. The variance of NHP during any periods from 9 years to 18 years of age in three facial types (3.4 degrees to 12.1 degrees ) is much more less than the variance of intracranial reference planes to the vertical (25 degrees to 36 degrees ). Cephalometric analyses upon NHP in different facial types among these four occasional radiograms are rather highly valid. Supported by Research Fund (No.300411) from Zhejiang Province.